Nassau University Medical Center, Nassau County Firefighters Burn Center, East Meadow, NY 11554, USA.
Burns. 2013 Feb;39(1):146-9. doi: 10.1016/j.burns.2012.02.015. Epub 2012 May 30.
Many burn patients experience more intense pain from the split thickness skin donor site than in the grafted burn wound in their postoperative period. Often, split thickness autografts are harvested from the lateral thigh area, which is innervated by the lateral femoral cutaneous nerve (LFCN). Sonographic nerve localization has been an increasingly popular technique to provide regional nerve blocks and we explore its role in improving pain control during skin harvesting. The LFCN was identified and blocked using ultrasound in 16 patients with a variety of wounds. The donor site was tested and marked after the injection. General anesthesia or sedation was administered after markings were completed. A postoperative survey was performed to assess the return of sensation at the donor site. All blocks were successful with adequate visualization of LFCN using ultrasound. Full anesthesia at the donor site, defined as absence of pain in response to a sharp object prick, was tested at 15 min and confirmed at 20 min after the block. The size of the anesthetized field ranged from 119 to 630 cm(2), with a mean surface area of 268.5 cm(2). Donor site sensation returned within 5-16 h with a mean time of 9.1h. Ultrasound guided LFCN block provides a simple and safe choice of anesthesia for harvesting skin from the lateral thigh.
许多烧伤患者在术后恢复期供皮区的疼痛比移植烧伤创面更剧烈。通常，从股外侧皮神经（LFCN）支配的大腿外侧区域采集断层皮片。超声神经定位已成为一种越来越受欢迎的提供区域神经阻滞的技术，我们探讨其在改善皮片采集过程中的疼痛控制中的作用。对 16 例各种创面的患者进行了超声定位和阻滞 LFCN。注射后对供皮区进行了测试和标记。标记完成后给予全身麻醉或镇静。术后进行调查，评估供皮区感觉的恢复情况。所有阻滞均成功，使用超声可充分显示 LFCN。在阻滞后 15 分钟和 20 分钟时，用尖锐物体刺痛来测试供皮区的完全麻醉（定义为无疼痛反应）。麻醉区域的大小从 119 到 630cm²不等，平均面积为 268.5cm²。供皮区感觉在 5-16 小时内恢复，平均时间为 9.1 小时。超声引导下 LFCN 阻滞为大腿外侧皮片采集提供了一种简单、安全的麻醉选择。
